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[Horner syndrome and brachial plexus blockade after epidural anesthesia for obstetric labor and cesarean section]

G Molins Ballabriga1, Y Vacas, F Jiménez

  • 1Departamento de Anestesiologia, Reanimación y Tratamiento del Dolor, Instituto Universitario Dexeus, Barcelona. gmolins@hotmail.com

Revista Espanola De Anestesiologia Y Reanimacion
|February 26, 2011
PubMed

A 30-year-old woman (ASA II, obese) in her 40th week of a first pregnancy required epidural analgesia for labor. When the cervix had dilated to 5 cm, the epidural infusion was started with a 9-mL bolus of 0.2% ropivacaine and 50 pg of fentanyl, after a negative test dose. An infusion of 0.2% ropivacaine and 1 microg/mL of fentanyl was started at a rate of 8 mL/h. A cesarean section was required after insufficient progress was made during 8 hours of labor. Eight milliliters of 0.75% ropivacaine was administered to provide anesthesia to T4; cesarean delivery was completed without complications. Early during postoperative recovery, in addition to motor blockade of the legs, the patient experienced a right brachial plexus blockade and Horner syndrome on the same side. Both effects disappeared spontaneously (1 and 4 hours later, respectively).

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